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TO: Hospital Providers, Physicians, Nurse Practitioners, Physician Assistants,
County Health Departments, Federally Qualified Health Centers, and Rural Health
Clinics
RE: New Coverage for Novavax COVID-19 Vaccine (for Non-Pharmacy Providers)
Information in
this Provider ALERT is in coordination with the ALERTs published January 11, 2021,
March 24, 2021, January 13, 2022, July 26, 2022, August 15, 2022, October 4,
2022, October 5, 2022, November 10, 2022, November 22, 2022, February 8, 2023, April
20, 2023, June 26, 2023, and October 4, 2023.
Effective for
dates of service on or after October 3, 2023, Medicaid covers the following new
procedure code for COVID-19 vaccines.
Procedure Code
|
Procedure Code Short Descriptor
|
Age Restriction
|
Medicaid Rate
|
91304
|
SARSCOV2
VAC 5MCG/0.5ML IM
|
12y
- older
|
$148.20
|
Medicaid enrolled
providers should not bill for the vaccine if using federally-allocated
vaccines.
To participate
in the administration of COVID-19 vaccine, Alabama providers must enroll in the
Alabama Department of Public Health (ADPH) ImmPRINT COVID-19 Vaccination
Program. Follow the steps in the ImmPRINT
Registration Roadmap to enroll.
Providers must
follow state and federal laws and regulations regarding administration of the
vaccine, as well as state and federal standing order guidelines for products
granted Emergency Use Authorization (EUA).
Providers with
billing questions should contact the Gainwell Technologies Provider Assistance
Center at 1-800-688-7989.
The Current Procedural Terminology (CPT) and Current
Dental Terminology (CDT) codes descriptors, and other data are copyright © 2023 American Medical Association
and © 2023 American Dental Association (or such other date publication of CPT and
CDT). All rights reserved. Applicable FARS/DFARS apply.